A previously unmentioned surgical observation in the treatment of intussusception

Intussusception is one of the most common causes of bowel obstruction in in fancy which may require surgical treatment. We have recently recognized a p athologically weakened linear area located on the wall of the reduced colon at operation, Thus, a retrospective study was conducted to evaluate the op erative and pathological findings of the resected bowel segments for the tr eatment of intussusception. A pathologically weakened longitudinal linear a rea was encountered in five patients. This line was strikingly antimesenter ic and under the taenia libera, The bowel wall was very thin and effaced on palpation along this whitish line and showed mucosal necrosis, disruption of the muscularis mucosa, and loss of some of the muscular tissue on micros copic examination. The line may result from compression of the inner layers of the bowel wall between the intussusceptum and the noncompliant taenia. Location on the antimesenteric border and under the taenia libera can be ex plained by local vascular compromise due to the distribution of the termina l arteries of the colon. Thus, the antimesenteric border as well as the mes enteric side should be checked carefully for a longitudinal weakened pressu re line, The recognition of such a potentially dangerous weak line on the b owel wall indicates resection.